Individual provider Active NPI

Jacqueline Alexander Clavo, CRNA

  • Certified Registered Nurse Anesthetist
  • Oakland, CA
National Provider Identifier
1790977312
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1308 Issued in CA
Practice address
1411 E 31St St
Oakland, CA 94602-1018
Phone
(510) 437-4366
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1308 CA Primary
Registered Nurse 163W00000X 408517 CA

Addresses

Primary practice location

1411 E 31St St
Oakland, CA 94602-1018

Mailing address

800 S Regatta Dr
Vallejo, CA 94591-6945
Phone (707) 644-4933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071008000253 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628163508 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willits Hospital IncGroup PAC ID 7416940697, 67 clinicians
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

1 Marcela Dr
Willits, CA 95490-5769
Phone (707) 459-6801

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599
  • Adventist Health Howard Memorial Hospital, Willits, CA, CCN 051310

Merit-based Incentive Payment System (MIPS)

Final score
89.41 of 100Reported as group
Quality
86.32
Promoting interoperability
95
Improvement activities
40
Cost
66.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
408517CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Aug 20, 2025 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2025 Accepting new patients
Anesthesia Services of San Joaquin, P.C. CurrentSince Nov 23, 2021 Accepting new patients
Willits Hospital Inc. CurrentSince May 26, 2021 Accepting new patients
Ukiah Adventist Hospital CurrentSince May 26, 2021 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

2315 Stockton Blvd
Ste 1200
Sacramento, CA 95817
Phone (916) 734-5394

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

1 Marcela Dr
Willits, CA 95490
Phone (707) 456-3001

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1790977312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S REGATTA DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945916945",
            "telephone_number": "707-644-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAVO",
        "first_name": "JACQUELINE",
        "middle_name": "ALEXANDER",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "1308",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "408517",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.